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Tuesday, October 12, 2010

To the rites of middle-age passage, some families are adding another: buying marijuana for aging parents.

Bryan, 46, a writer who lives in Illinois, began supplying his parents about five years ago, after he told them about his own marijuana use. When he was growing up, he said, his parents were very strict about illegal drugs.

“We would have grounded him,” said his mother, who is 72.

But with age and the growing acceptance of medical marijuana, his parents were curious. His father had a heart ailment, his mother had dizzy spells and nausea, and both were worried about Alzheimer’s disease and cancer. They looked at some research and decided marijuana was worth a try.

Bryan, who like others interviewed for this article declined to use his full name for legal reasons, began making them brownies and ginger snaps laced with the drug. Illinois does not allow medical use of marijuana, though 14 states and the District of Columbia do. At their age, his mother said, they were not concerned about it leading to harder drugs, which had been one of their worries with Bryan.

“We have concerns about the law, but I would not go back to not taking the cookie and going through what I went through,” she said, adding that her dizzy spells and nausea had receded. “Of course, if they catch me, I’ll have to quit taking it.”

This family’s story is still a rare one. Less than 1 percent of people 65 and over said they had smoked marijuana in the last year, according to a 2009 survey by the federal Substance Abuse and Mental Health Services Administration. But as the generation that embraced marijuana as teenagers passes into middle age, doctors expect to see more marijuana use by their elderly patients.

“I think use of medical marijuana in older people is going to be much greater in the future,” said Dan G. Blazer, a professor of geriatric psychology at Duke University who has studied drug use and abuse among older people.

The rate for people ages 50 to 65 who said they smoke marijuana was nearly 4 percent — about six times as high as the 65-and-over crowd — suggesting that they were more likely to continue whatever patterns of drug use they had established in their younger years. In both age groups, the rate of marijuana abuse was very low, about 1 in 800.

Cannabinoids, the active agents in marijuana, have shown promise as pain relievers, especially for pain arising from nerve damage, said Dr. Seddon R. Savage, a pain specialist and president of the American Pain Society, a medical professionals’ group.

Two cannabinoid prescription drugs are approved for use in this country, but only to treat nausea or appetite loss. And while preliminary research suggests that cannabinoids may help in fighting cancer and reducing spasms in people with multiple sclerosis or Parkinson’s disease, the results have been mixed.

Dr. Savage said doctors should be concerned about older patients using marijuana. “It’s putting people at risk of falls, impaired cognition, impaired memory, loss of motor control,” she said. “Beside the legal aspects, it’s unsupervised use of a pretty potent drug. Under almost all circumstances, there are alternatives that are just as effective.”

Dr. Savage added, however, that there was a considerable range of opinions about marijuana use among pain specialists, and that many favored it.

Older people may face special risks with marijuana, in part because of the secrecy that surrounds illegal drug use, said Dr. William Dale, section chief of geriatrics and palliative medicine at the University of Chicago Medical Center, who said he would not oppose a law allowing medical marijuana use in Illinois.

The drug raises users’ heart rates and lowers their blood pressure, so doctors needed to weigh its effects beside those of other medications that users might be taking, he said. But patients do not always confide their illegal drug use, he said.

“It’s a fine balance between being supportive of patients to gain their trust and giving them your best recommendations,” Dr. Dale said. “I wasn’t taught this in medical school.”

For some families, marijuana, which was once the root of all their battles, has brought them closer together. Instead of parental warnings and punishment, there are questions about how to light a water pipe; instead of the Grateful Dead, there are recipes for low-sodium brownies.

But for parents, there is also the knowledge that they are putting their children at risk of arrest.

“I was very uncomfortable getting my son involved,” said the father of Alex, 21. The father, who is 54, started using marijuana to relieve his pain from degenerative disc disease. He soon discovered that Alex, who lives in Minnesota a few miles away, had access to better marijuana than he did.

Alex’s father had smoked marijuana when he was younger; Alex, by contrast, had been active in antidrug groups at his school and church. In college, he started smoking infrequently and studying marijuana’s medicinal properties.

“When he told me he was using cannabis, I think he expected it to be a bigger deal for me,” Alex said. “But it opened my eyes to what he was going through.”

Before trying marijuana, Alex’s father took OxyContin, a narcotic, which he said made him “feel like a zombie.” He also took antidepressants to relieve the mood disorder he associated with the OxyContin. Marijuana has helped him cut down on the painkillers, he said.

He and Alex have smoked together twice, but it is not a regular practice, both said. Yet they say the drug has strengthened their relationship.

“We spend our bonding time making brownies,” Alex said.

Florence, 89, an artist who lives in New York, smokes mainly for relief from her spinal stenosis — usually one or two puffs before going to sleep, she said. She buys her pipes through an online shop and gets her marijuana from her daughter, Loren, who is 65.

“A person brings it to me,” said Loren, who uses marijuana recreationally. “I’m not out on a street corner.” Florence said that she had told all of her doctors that she was using marijuana, and that none had ever discouraged her or warned of interactions with her prescription drugs, including painkillers.

“I think I’ve influenced my own physician on the subject,” she said. “She came to me and asked me for some for another patient.”

A version of this article appeared in print on October 10, 2010, on page A14 of the New York edition.